Akbulut Ilkay, Varol Zeynep Sedef, Akca Veysel, Serin Basak Gol, Erogul Emel, Odemiş Ilker, Senbayrak Seniha, Atalay Sabri
Department of Infectious Diseases and Clinical Microbiology, Health Sciences University Tepecik Training and Research Hospital, Yenisehir, Gaziler Cd No: 468, 35020 Konak, Izmir, Türkiye.
Department of Public Health, Izmir Health Directorate, Izmir, Türkiye.
BMC Infect Dis. 2025 Apr 23;25(1):587. doi: 10.1186/s12879-025-10988-2.
INTRODUCTION/OBJECTIVE: This Turkish study aimed to investigate the factors that contribute to the failure of virological suppression in people with human immunodeficiency virus (HIV) receiving antiretroviral therapy (ART). The factors evaluated were sociodemographic characteristics, opportunistic infections, polypharmacy, comorbidities, and the ART regimen used. The purpose of this investigation was to obtain important insights that can be utilized to improve treatment strategies at both individual and public health levels.
This multicenter retrospective case-control study compared data from 263 patients with suppressed viremia with 125 with unsuppressed viremia, all treated at one of three hospitals in the Aegean region of Turkiye. Sociodemographic and clinical characteristics and ART regimen details were compared between the two groups. Logistic regression analysis was used to identify the predictors of virological failure.
Patients with unsuppressed viremia were significantly more likely to be older, have lower educational levels, and reside in large cities. Our logistic regression analysis showed that each additional month since HIV diagnosis increased the risk of virological failure by 2%. Moreover, each 1% increase in nadir CD4 + T-cells reduced the risk of virological failure by 4%. Opportunistic infections increased the risk of virological failure by 3.25 times. Interestingly, virological failure was 6.5 times more likely in patients who did not suffer ART side effects.
This study identified the sociodemographic, clinical, and treatment-related factors that contribute to virological failure in people with HIV in Turkiye. This can be utilized to develop individualized treatment strategies and improve virological control and clinical outcomes.
引言/目的:这项土耳其的研究旨在调查接受抗逆转录病毒疗法(ART)的人类免疫缺陷病毒(HIV)感染者病毒学抑制失败的影响因素。评估的因素包括社会人口学特征、机会性感染、多种药物治疗、合并症以及所使用的ART方案。这项调查的目的是获得重要见解,以用于改善个体和公共卫生层面的治疗策略。
这项多中心回顾性病例对照研究比较了263例病毒血症得到抑制的患者与125例病毒血症未得到抑制的患者的数据,所有患者均在土耳其爱琴海地区的三家医院之一接受治疗。比较了两组患者的社会人口学和临床特征以及ART方案细节。采用逻辑回归分析来确定病毒学失败的预测因素。
病毒血症未得到抑制的患者年龄更大、教育水平更低且居住在大城市的可能性显著更高。我们的逻辑回归分析表明,自HIV诊断以来每增加一个月,病毒学失败的风险增加2%。此外,最低点CD4 + T细胞每增加1%,病毒学失败的风险降低4%。机会性感染使病毒学失败的风险增加3.25倍。有趣的是,未出现ART副作用的患者病毒学失败的可能性高6.5倍。
本研究确定了导致土耳其HIV感染者病毒学失败的社会人口学、临床和治疗相关因素。这可用于制定个体化治疗策略并改善病毒学控制和临床结局。